caa a22 4500 388115807 CHVBK 20180307125406.0 cr unu---uuuuu 161130e199901 xx s 000 0 eng 10.1017/S1047951100007496 doi S1047951100007496 pii (NATIONALLICENCE)cambridge-10.1017/S1047951100007496 Outcome of pregnancy in women with congenital heart disease [Elektronische Daten] Improvements in diagnosis and surgical technique for correction have led to an increasing number of women with congenital heart disease reaching the child-bearing age. Pregnancy places considerable strain on the heart and circulation and necessitates marked cardiorespiratory adaptation. Today, with the exception of the Eisenmenger syndrome, there is no increased mortality associated with pregnancy in congenital heart disease. In contrast, there is still considerable morbidity, due to congestive heart failure, thromboembolic complications and disturbances of rhythm. Fetal outcome is complicated by a high rate of spontaneous abortions (20-25%), retardation of fetal growth, and premature delivery (almost 100% in cyanotic mothers). Based on an extensive review of the literature, we discuss the specific risks in pregnancy depending on the hemodynamic situations produced by different heart defects. We also discuss the risks and advantages of different regimens for anticoagulation. Counselling concerning contraception is frequently inadequate. The most important problems are thromboembolic complications with the use of hormonal contraception, and hyper- and dysmenorrhea in those using intrauterine devices. Finally, the genetic risks must be considered, differentiating between single gene defects and the sex of the parents suffering from congenital heart diseases. Copyright © Cambridge University Press 1999 Pregnancy nationallicence congenital heart disease nationallicence maternal risk nationallicence fetal risk nationallicence anticoagulation nationallicence genetic risk nationallicence Schmaltz A. A. Department ofPaediatric Cardiology, Children's Hospital, and Department of Obstetrics and Gynaecology, University Hospital Essen, Germany Neudorf U. Department ofPaediatric Cardiology, Children's Hospital, and Department of Obstetrics and Gynaecology, University Hospital Essen, Germany Winkler U. H. Department ofPaediatric Cardiology, Children's Hospital, and Department of Obstetrics and Gynaecology, University Hospital Essen, Germany Cardiology in the Young Cambridge University Press 9/1(1999-01), 88-96 1047-9511 9:1<88 1999 9 CTY https://doi.org/10.1017/S1047951100007496 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1017/S1047951100007496 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schmaltz A. A. Department ofPaediatric Cardiology, Children's Hospital, and Department of Obstetrics and Gynaecology, University Hospital Essen, Germany NATIONALLICENCE 700 1- Neudorf U. Department ofPaediatric Cardiology, Children's Hospital, and Department of Obstetrics and Gynaecology, University Hospital Essen, Germany NATIONALLICENCE 700 1- Winkler U. H. Department ofPaediatric Cardiology, Children's Hospital, and Department of Obstetrics and Gynaecology, University Hospital Essen, Germany NATIONALLICENCE 773 0- Cardiology in the Young Cambridge University Press 9/1(1999-01), 88-96 1047-9511 9:1<88 1999 9 CTY CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge